Arrhythmias & electrophysiologyCohort study
Left atrial sphericity and strain augment risk prediction in patients with embolic stroke of undetermined source
- prospective
Authors' conclusion
LA reservoir and conduit strain, and circularity have independent and incremental association with the occurrence of recurrent-stroke and new-AF in ESUS patients. This may represent measurable non-invasive markers of atrial cardiomyopathy in a subset of ESUS patients and enable risk-stratification and targeted intervention. Future longitudinal studies are needed to confirm these findings.
Study context
- Population
- Ischaemic stroke patients: Embolic Stroke of Undetermined Source (ESUS) and non-cardioembolic stroke (non-CES)ESUS 203 · non-CES 256
- Participants
- 203 vs 256
- Exposure
- Left atrial (LA) parameters in ESUS patients compared to non-CES patients; LA parameters associated with recurrent-stroke and new-AF in ESUS patients
- ESUSn = 203
- non-CESn = 256
Main finding
As reported in the abstract
ESUS patients had increased LA volume, reduced reservoir and contractile strain, and increased circularity compared to non-CES patients
P < 0.002 for all
Observational data: associations, not effects.
Further findings
- Recurrent-stroke; recurrent-stroke or new-AF (ESUS patients)
- 36(18%) · recurrent-stroke · recurrent-stroke or new-AF 54(27%)
Association of LA parameters with recurrent-stroke and recurrent-stroke or new-AF (ESUS patients)
- Larger LA volume, reduced phasic LA strain (reservoir, contractile and conduit), and increased circularity were associated with both outcomes
- P < 0.05 for all
- Independent and incremental value for reservoir and conduit strain, and circularity, in identifying patients at risk of recurrent-stroke and new-AF
Original publication
Summarised from the published abstract; every number is checked against it